Scrub typhus – A case series from the state of Sikkim, India

Scrub typhus is one of the leading causes of acute febrile illness in India. It is associated with rash and often an eschar, which responds dramatically to antibiotics. In some cases, it results in serious illness leading to multiple organ involvement and finally death. The various clinical manifestations of scrub typhus arise mainly due to systemic vasculitis, caused by direct effects of organism as well as exaggerated immune response. The disease course is often complicated, leading to mortality in the absence of treatment. Here, in this case series, we describe three cases depicting the typical manifestations which a patient of scrub typhus can present with highlighting the fact that high index of clinical suspicion is of utmost importance for this deadly disease.